Notes from the field

How I Helped a Pregnant Mum Avoid Severe Complications Whilst Volunteering in Reynosa

by Katie G., GRM Volunteer Nurse

*Please note, names have been changed to protect our patient’s identity

In November 2022, GRM met Fabienne*,  a Haitian refugee living in the Senda de Vida Shelter, who was 28 weeks pregnant and presenting with a medical condition called pre-term premature rupture of the membranes (PPROM), meaning her water broke too early. This condition is dangerous for the mother due to high risk of infection and high probability of emergency cesarean section and also for the premature baby, whose lungs are not fully developed and will need NICU care immediately after delivery.

Photo: Nurse Katie, a GRM volunteer and the author of this story, setting up for clinic hours in Reynosa.

Doctors Without Borders notified GRM that this woman had been turned away from the Reynosa emergency department because they did not have NICU capacity. So I went with others to collect the patient and her family from the shelter and brought them to the clinic at Casa de Lulu.

When Dr. William, a local GRM staff doctor, contacted the maternity hospital in Reynosa, he was told that all of the NICU beds were in use and they could not accept any more patients. At this point, the GRM team agreed that Fabienne would not be able to receive the immediate care she needed in Mexico and arranged for her to be received at a U.S. hospital in Texas via our medical referral cost coverage program (a program that is facilitated through GRM’s generous donor community for urgent and complex medical cases like this).

GRM contacted Lawyers for Good Government in order to initiate medical asylum paperwork and expedite Fabienne’s crossing. In the meantime, Dr. William and Nurse Katie gave her an injection of steroids to help the baby’s lungs develop and an injection of antibiotics to prevent infection.  As soon as the legal paperwork was completed, GRM started assisting Fabienne and her family cross the border.

At this point, Fabienne was in pain, feeling contractions and leaking a significant amount of amniotic fluid. Nurse Katie used a GRM wheelchair to push the patient across the border bridge while another volunteer nurse, Lia, accompanied her family close behind. Once at the bridge, they were met by CBP agents and brought to the Immigration Center. It took about an hour to get through the Immigration Center before the patient was released and an ambulance was called. Katie accompanied Fabienne in the ambulance to the Rio Grande Hospital with Lia and the family following behind in an Uber.

Above right: Nurse Katie and patient in U.S. Ambulance after crossing.

At the hospital, Fabienne was immediately transferred through the ER and into the Labor and Delivery Unit. The L&D staff were pleased to hear she had already received antibiotics and a steroid injection at the GRM Clinic, noting GRM’s quick thinking and fast action potentially helped the patient avoid an emergency premature c-section, and certainly helped prevent infection or worse complications.

Once Fabienne was safely settled in the L&D unit, GRM staff focused on the patient’s family. Unfortunately, the hospital would not allow the family to stay in the hospital room with the patient. However, our Reynosa Project Manager contacted our friends, the Angry Tias and Abuelas, another local nonprofit, who provided a three-day stay in a nearby hotel for the family.

Photo: Patient receiving treatment in McAllen, TX in Labor & Delivery Unit.

Our patient and her family were grateful for the medical services provided by GRM and told our staff this was the first time in months that they felt safe and optimistic about the future.

While it is terrible to think of what the outcome could have been without the intervention of the GRM team, Lawyers for Good Government, Doctors Without Borders, the Angry Tias & Abuelas, and everyone else involved in this patient’s care, this situation illustrates exactly how important our work is.

GRM is truly an organization that stands by the principles of the humanitarian imperative, they bring impartial assistance to those most in need and deserving. They are an organization I am proud to say I work with.

 

BLOG POSTS ARE THE OPINION OF THE AUTHOR AND DO NOT NECESSARILY REPRESENT THE VIEW OF GRM

Press Releases

Global Response Medicine Reynosa Project Update – November 2022


(17 November 2022, Reynosa, Tamaulipas in Mexico, several thousand people wait outside one of the main shelters, Senda de Vida. Photo credit: Brendon Tucker)

GRM REYNOSA (1 January 2022 to 31 October 2022):

REYNOSA: The Mexican Town that Acts as a Barometer for World Politics

The number of people arriving in Reynosa continues to outstrip those being allowed into the United States, causing the migrant population to grow. As a result, our outreach team is working hard to publicize our clinics and emergency services among new arrivals.

There are currently around 10,000 people on the streets of Reynosa, Tamaulipas, in northern Mexico. Although, without an official population count, we estimate that there could be as many as 15,000. Global Response (GRM) provides medical care to the population living on the streets in Reynosa’s shelters including:
Campamento Rio (~500 people), Senda de Vida I (~1700),
Senda de Vida II (~1500),
Casa Migrante (~200), and Casa de Clinica (~50).

We have tested over 30,000 people this year for COVID-19. Positive COVID results are now extremely rare.

GRM medical providers have seen almost 10,000 unique patients in Reynosa this year (in over 12,000 consultations), 1,300 of whom were seen in October. Typically, complaints are a direct result of the inhumane living conditions: skin conditions, gastrointestinal disorders, and a significant percent of maternal health cases.

Telemedicine consults are available for specialty cases and insecure locations:

  • Since the end of March 2022, we have provided over 120 pediatric telemedicine consults in conjunction with University of California San Francisco (UCSF) to residents of the Kaleo shelter in Reynosa, which our team does not physically visit as it is located to the west of the city in an area that we consider unsafe to travel.
  • We have also provided telemedicine consults to Russian patients – where we were unable to find a local translator – through a partnership with Massachusetts General Hospital. Through these consults, our team has diagnosed conditions such as anxiety, depression, and PTSD.


17 November 2022, Reynosa, Tamaulipas, GRM Volunteer, Jane Cross, pediatrician, treats a 2-year-old girl from Haiti, complaining of abdominal pain. Photo credit: Jade Bachtold

On average, we receive around one emergency call per day. The cases, varying in their urgency, have involved respiratory distress, trauma cases, maternal health complications, and emergent medical conditions such as heart attacks, strokes, and appendicitis.

Recent complicated cases have involved a young boy with Tuberculosis, a husband who was diagnosed with terminal cancer while his wife was in a maternal health consult with one of our physicians, and two patients with leprosy. When appropriate resources are not available in Mexico we attempt to place patients in hospitals in the US via humanitarian parole, although unfortunately not all patients survive the wait.

Changes in Citizenship as a Reflection of World Politics:

We have noticed that the town’s population reflects global events. On 21 September 2022, Russian President Putin introduced his conscription decree. A few weeks later, the migrant population in Reynosa saw Russians, Uzbecs,

and Chechens arriving in small groups with several stating ‘avoiding conscription’ as their reason for travel.

The following graph, based on Mexican Government statistics, shows the numbers of Russians entering Mexico in 2022. While the numbers are lower than the beginning of the year, they are trending slightly upwards, which tracks with what we are seeing in Reynosa. It is worth noting that Russian citizens do not currently need a visa to enter Mexico – they can apply online for an electronic travel authorization, making it relatively easy to enter the country.

Data from the Mexican Institute for Migration 2022:

[1]

The number of Russians encountered by Customs and Border Protection was also higher in September – the most recent data – than any month since May 2022. In October, there were fewer Venezuelans encountered at the southwest border but “encounters of Cuban and Nicaraguan asylum seekers fleeing their authoritarian regimes continue to be at an historic high. This reflects the challenge that is gripping the hemisphere, as displaced populations flee authoritarianism, corruption, violence, and poverty”, said CBP Acting Commissioner Troy Miller.[2]

Whatever happens in the world, it tends to follow that there are changes to the migrant population in Northern Mexico. With the disruption in Haiti, our clinic population saw a significant increase in Haitians in February and May of this year, following an increase in Haitians entering Mexico at the end of 2021. We saw a sharp increase in the number of Guatemalans after the twin hurricanes in 2020 and Afghan families after the 2021 pull out of US troops. At the start of the war in Ukraine in 2022, our Mexico clinics treated Ukrainian patients whilst GRM had another team in Ukraine doing the same.

That said, in spite of the increased number of Venezuelans entering Mexico, Venezuelans are underrepresented in the migrant population in Reynosa; we have seen fewer than 10 Venezuelan patients this year.

See here for a breakdown of our clinic’s population by month and by nationality.

Additional Background to Reynosa:

Reynosa accommodation is offered on a “conveyor belt system”. New arrivals have nothing as the shelters are full, eventually they may be given a tent by those moving into a shelter space and from the shelters they may be put on a list to assess whether or not they can cross to the United States.

By way of background, many people found themselves trapped on the border after the Trump administration implemented migration policies that aimed to prevent people entering the United States. The Biden Administration entered the White House vowing to end both of these policies although to date they

remain in place with a recent court decision requiring the US Government to terminate Title 42 within the next few weeks.[3]

Note that the US Government considers Tamaulipas to be so dangerous that it has issued a stage 4 – do not travel – advisory.

[1] http://portales.segob.gob.mx/work/models/PoliticaMigratoria/CEM/Estadisticas/Boletin es_Estadisticos/2022/Boletin_2022.pdf
[2] https://www.cbp.gov/newsroom/national-media-release/cbp-releases-october-2022- monthly-operational-update
[3] https://www.aclu.org/press-releases/federal-court-strikes-down-title-42-major-victory- asylum-seekers

Please get in touch if you would like to arrange a visit, schedule an interview with one of our staff or patients, visit the shelters in Reynosa, or procure images from the clinics.

For further information please contact:
[email protected]

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In The News

CNN – Keeping Title 42 in place won’t slow US-Mexico border crossings, officials say

by Priscilla Alvarez
Original posted on CNN, May 24, 2022

court ruling blocking the termination of a Trump-era pandemic restriction at the US-Mexico border is unlikely to slow border crossings, Biden administration officials say, as migration in the Western hemisphere reaches new highs.

Since taking office, President Joe Biden has faced mounting pressure over his handling of the US-Mexico border, dividing members of his own party following a decision by the US Centers for Disease Control and Prevention to lift Title 42, which allows authorities to swiftly turn people away at the border, effectively barring migrants from seeking asylum.

Republicans hammered the administration for not being tough enough on the border. Some Democrats and immigrant advocates, meanwhile, say the White House has waited too long to rescind it. Regardless, a federal court ruling means the administration will be forced to keep it in effect for now.

Along the northern border of Mexico, advocates say some migrants remain undeterred and desperate. “I don’t think that just because Title 42 didn’t go away today that people are thinking that was the one and only way they were going to get over,” said Sam Bishop, Mexico country director for Global Response Management.

“To me, the lack of some sort of visible and major outcry today in particular or since Friday, is kind of an indication that this isn’t the only thing they’re necessarily waiting for,” Bishop, who works directly with migrants, added.

Over the weekend, following the court ruling, Border Patrol agents arrested more than 500 migrants in the Rio Grande Valley sector alone, which covers south Texas, according to US Customs and Border Protection. And in Yuma, Arizona, border agents arrested over 1,500 migrants in a 24-hour period over the weekend, a Homeland Security official told CNN.

Migration is at new highs amid deteriorating conditions in Latin America that were exacerbated by the coronavirus pandemic. At the US southern border, about 40% of border crossers are now from countries outside of Mexico and the Northern Triangle countries of Guatemala, Honduras and El Salvador, according to a Homeland Security official.

The Department of Homeland Security, officials say, is operating under the belief that numbers will remain high even with Covid-19 border restrictions still in place. The number of border crossings generally increase in the spring, but the current pace of record numbers highlights the continued urgency on the US-Mexico border.

For months, DHS prepared for the future lifting of Title 42, which was invoked at the onset of the coronavirus pandemic, while grappling with around 7,000 border crossers daily.

In a statement following Friday’s ruling, DHS maintained the department would press forward with preparations to manage a potential increase of migrants at the border. Officials are also racing to strike agreements with countries in the region to stem the flow of migrants journeying to the US southern border.

DHS is similarly working with Mexico to mitigate traffic along key areas on the US southern border, like patrols, checkpoints, and going after smugglers, the agency official said.

More than 6 million Venezuelan refugees and migrants have fled the country, according to DHS. Nicaraguans have also increasingly been migrating, as well as Haitians who had moved to the region years ago. Arrangements on migration management have already been struck with Costa Rica and Panama – two countries that migrants pass through when heading to the US southern border.

In the interim, though, a range of nationalities continue to journey to the US southern border. Some of those pose a challenge to the Biden administration because they can’t easily be expelled under Title 42 or deported – at times, fueling more migrants from those regions.

Cubans, for example, are more difficult to expel given poor US-Cuba relations. Between last October and April, border authorities stopped nearly 114,000 Cubans along the US-Mexico border, far outpacing recent years, CBP data shows.

“What US enforcement policy tends to do over the long term is shape who comes, rather than how many people come,” said Andrew Selee, president of the Migration Policy Institute, a nonpartisan think tank. “Title 42 matters on shaping who comes, but it may not be the biggest factor in how many people come.”

Still, Republicans and vulnerable Democrats urged the Biden administration to keep Title 42 in effect, arguing it was a necessary tool until a comprehensive plan to manage the border was in place.

Friday’s ruling, which found the administration should’ve gone through the months-long rulemaking process before terminating the authority, means Title 42 will likely stay in place for months to come.

“We’ll continue seeing the bottle neck on the Mexican side of the border and it really doesn’t resolve much,” Tucson, Arizona, Mayor Regina Romero told CNN, when asked about Friday’s ruling. “I’ve said over and over again that Title 42 is not an immigration tool. It is a public health order.”

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Yesterday, GRM founder Pete Reed and was killed in Bakhmut, Ukraine.

Yesterday, GRM founder Pete Reed was killed in Bakhmut, Ukraine. Pete was the bedrock of GRM, serving as Board President for 4 years. In January, Pete stepped away from GRM to work with Global Outreach Doctors on their Ukraine mission and was killed while rendering aid.

This is a stark reminder of the perils rescue and aid workers face in conflict zones as they serve citizens caught in the crossfire. Pete was just 33 years old, but lived a life in service of others, first as a decorated US Marine and then in humanitarian aid. GRM will strive to honor his legacy and the selfless service he practiced.

We fully support Pete’s family, friends, and colleagues during this devastating time.